Critical care clinics
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Telehealth in intensive care units (TeleICU) is the provision of critical care using audio-visual communication and health information systems across varying clinical and geographically dispersed settings. The optimal structure of a TeleICU team is one that leverages expert clinical knowledge to address the needs of critical care patients, regardless of hospital location or availability of an onsite intensivist. Information related to the optimal TeleICU team structure is lacking. This article examines the optimal TeleICU team composition, which is one that incorporates the use of an interdisciplinary approach, leverages technology, and is cognizant of varying geographic locations.
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Critical care clinics · Jul 2019
ReviewEvolution of the Intensive Care Unit Telemedicine Value Proposition.
Advances in clinical information sciences, telecommunication technologies, electronic health records, early warning systems, automated acuity assessment, and clinician communication support systems have allowed current-generation intensive care (ICU) telemedicine systems to address the inefficiencies of the failed advice-upon-request ICU telemedicine model. Value is related to the ability of health care systems to leverage ICU telemedicine resources to provide care. Local financial benefits of ICU telemedicine program implementation depend on changing behavior to better focus on activities that reduce the duration of critical illness and length of stay.
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Critical care clinics · Jul 2019
ReviewIntensive Care Unit Telemedicine in the Era of Big Data, Artificial Intelligence, and Computer Clinical Decision Support Systems.
This article examines the history of the telemedicine intensive care unit (tele-ICU), the current state of clinical decision support systems (CDSS) in the tele-ICU, applications of machine learning (ML) algorithms to critical care, and opportunities to integrate ML with tele-ICU CDSS. The enormous quantities of data generated by tele-ICU systems is a major driver in the development of the large, comprehensive, heterogeneous, and granular data sets necessary to develop generalizable ML CDSS algorithms, and deidentification of these data sets expands opportunities for ML CDSS research.
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Critical care clinics · Jul 2019
ReviewIntensive Care Unit Telemedicine: Innovations and Limitations.
Intensive care unit (ICU) telemedicine is an established entity that has the ability to not only improve the effectiveness, efficiency, and safety of critical care, but to also serve as a tool to combat staffing shortages and resource-limited environments. Several areas for future innovation exist within the field, including the use of advanced practice providers, robust inclusion in medical education, and concurrent application of advanced machine learning. The globalization of critical care services will also likely be predominantly delivered by ICU telemedicine. Limitations faced by the field include technical issues, financial concerns, and organizational elements.
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Critical care clinics · Jul 2019
ReviewQuality Improvement and Telemedicine Intensive Care Unit: A Perfect Match.
The health care delivery system is complex. New technologies offer new treatment options. The process of quality improvement includes system re-engineering. ⋯ Its core characteristic is the need for a merger of human and machine activity. Optimal use of quality improvement tools can lead to improved patient-centered outcomes. This article outlines how quality improvement tools can be used to facilitate the patient-centered collaboration with a focus on defining evidence-practice gaps, developing actionable metrics, analyzing the impact of proposed interventions, quantifying resources, prioritizing improvement plans, evaluating results, and diffusing best practices.